Splenic vein thrombosis after splenectomy: frequency and role of imaging.

PURPOSE: To assess the frequency of splenic vein thrombosis (SVT) after splenectomy and its consequences on patient treatment.

MATERIALS AND METHODS: A group of 183 consecutive patients who underwent splenectomy were evaluated. Of these patients, 119 underwent postoperative ultrasound (US) or computed tomography.

RESULTS: SVT was diagnosed in 13 of 119 patients in the first 2 weeks after surgery. In these 13 patients, splenectomy had been performed for hematologic disorders (n = 12) or trauma (n = 1). Seven of the 13 patients were asymptomatic. After anticoagulant therapy, follow-up US of 12 patients showed resolution of thrombosis with no complications in 10 patients; two patients developed cavernous transformation of the portal vein.

CONCLUSION: Since only 65% of patients underwent imaging, the true frequency of SVT could not be determined; however, it occurred in at least 7% of patients who underwent splenectomy. Routine Doppler US should be performed after splenectomy to allow early anticoagulant therapy in patients with SVT.